Rogers A J, Leigh J, Berry G, Ferguson D A, Mulder H B, Ackad M
National Institute of Occupational Health and Safety, Sydney, Australia.
Cancer. 1991 Apr 1;67(7):1912-20. doi: 10.1002/1097-0142(19910401)67:7<1912::aid-cncr2820670716>3.0.co;2-y.
Lung tissue from 221 definite and probable cases of malignant mesothelioma reported to the Australian Mesothelioma Surveillance Program from January 1980 through December 1985 and from an age-sex frequency matched control series of 359 postmortem cases were examined by light microscopic (LM) and analytical transmission electron microscopic (TEM) analysis and energy dispersive x-ray analysis (EDAX). Concentrations of total fibers (coated and uncoated) (LM), crocidolite, amosite, chrysotile, and unidentified amphibole (TEM) (fibers/g dry lung tissue) were measured. Fiber concentrations less than 10 microns in length and greater than or equal to 10 microns in length were separately quantified. By comparing cases (221) and controls (359 LM, 103 TEM), odds ratios for increasing fiber concentrations compared with less than 15,000 fibers/g (LM) and less than 200,000 fibers/g (TEM) (the respective detection limits) were calculated. Univariate analyses showed statistically significant dose-response relationships between odds ratio and fiber concentration for all fiber concentration measures. The relationship between log(odds ratio) and log(fiber concentration) was linear. Multiple logistic regression analysis showed that a model containing crocidolite greater than or equal to 10 microns, amosite less than 10 microns, and chrysotile less than 10 microns as explanatory variables best described the data. The odds ratios for a X10 increase in fiber concentration (fibers/micrograms) were as follows: crocidolite greater than or equal to 10 microns, 29.4 (95% confidence interval [CI], 3.6 to 241); chrysotile less than 10 microns, 15.7 (95% CI, 6.1 to 40); amosite less than 10 microns, 2.3 (95% CI, 1.0 to 5.3). An additive risk model gave similar results. In a subgroup of cases and controls with only chrysotile in the lungs, a significant trend in odds ratio with increasing fiber content was found.
对1980年1月至1985年12月期间向澳大利亚间皮瘤监测项目报告的221例确诊和疑似恶性间皮瘤病例的肺组织，以及359例年龄 - 性别频率匹配的尸检对照病例系列的肺组织进行了光镜（LM）、分析型透射电镜（TEM）分析和能量色散X射线分析（EDAX）。测量了总纤维（包被和未包被）（光镜）、青石棉、铁石棉、温石棉和未鉴定闪石（透射电镜）（纤维/克干肺组织）的浓度。分别对长度小于10微米和大于或等于10微米的纤维浓度进行了定量。通过比较病例（221例）和对照（359例光镜、103例透射电镜），计算了与低于15,000纤维/克（光镜）和低于200,000纤维/克（透射电镜）（各自的检测限）相比纤维浓度增加的优势比。单因素分析显示，所有纤维浓度测量的优势比与纤维浓度之间存在统计学上显著的剂量 - 反应关系。log（优势比）与log（纤维浓度）之间的关系是线性的。多因素logistic回归分析表明，一个包含长度大于或等于10微米的青石棉、长度小于10微米的铁石棉和长度小于10微米的温石棉作为解释变量的模型最能描述数据。纤维浓度（纤维/微克）每增加10倍的优势比如下：长度大于或等于10微米的青石棉，29.4（95%置信区间[CI]，3.6至241）；长度小于10微米的温石棉，15.7（95%CI，6.1至40）；长度小于10微米的铁石棉，2.3（95%CI，1.0至5.3）。相加风险模型给出了类似的结果。在肺中仅含温石棉的病例和对照亚组中，发现优势比随纤维含量增加有显著趋势。
